Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 042232 | GA |
N | 2081P2900X | Pain Medicine | 042232 | GA |
NPI | 1417017799 |
---|---|
Provider Name | Richard James Donadio |
First Address | Rome, GA 30165-1369 |
Second Address | Rome, GA 30165-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 23/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000712016A | (05) | GA |
G34183 | (02) |